Monday Morning Update 2/15/10

From Conrad: “Re: Bassett Healthcare and their Stories of Success program. If it’s as good as the Go Red for Women/Put a Little Love In Your Heart video on their home page, they are doing all right. It’s clear they have employees who really like working there.” It’s kind of a Pink Glove Dance variant. Pretty good. I’m a sucker for this stuff.

From Talk of the Town: “Re: Allscripts. Two of the Allscripts sales veterans to leave were some of John’s boys from the original Medic lineup. The only thing surprising to me was that they have hung around this long. Combined with the exit of another of his sales guys from John’s golf company makes me wonder what John is up to these days.” He has five golf clubs now (the big real estate kind, not the sticks that badly dressed men hit balls with), although that may not be the best business in the world given the economy and lower property values. Not that he needs the money.

From Fact Finder: “Re: Sunquest. Take a look at the jobs posted to their Web site today. With that many sales jobs, it looks to me more than 30% left!” That’s quite a list — a clinical product specialist, two inside sales account managers, a regional VP, and six sales executives. Not the best timing with HIMSS booth duty coming up. From the “glass half full” side of the argument, they have jobs if you’re looking.

A physician’s Wall Street Journal editorial on EMRs ends with this:

If electronic records are only used to optimize billing and improve chart audits, patients will see little benefit. I doubt my patients received better care from the change.  Electronic records can only play a supporting role in a broader effort to change our troubled system. Until our health care system imagines patients as more than grist for billing, I will happily take my chances with a colleague’s inscrutable scrawl over a phone-book-sized stack of computer printouts.

HHS throws down another $1 billion for HIT, with $386 million in HIE grants (ranging from $600K to $38 million), $375 million for 32 Regional Extension Centers ($5.3 to $28.5 million), and $227 million for job training ($2 to $5 million). The jobs training one, in particular, has some odd recipients (Goodwill Industries and Spanish Speaking Unity Council, for example). I could write a bunch of stuff about this, but it’s kind of pointless until we see how those groups plan to spend our money. It better be good to be worth a billion dollars.

Cisco apparently fares much better than Microsoft and Google when it comes to healthcare, with nearly double their percentage of “positive” impressions. New poll to your right, for those going to HIMSS: what’s the last full day you’ll be there? I’m heading home Thursday, but the last I’ll see of the conference will be Wednesday (sorry, Sully).

Inga is putting together a list of HIStalk sponsors exhibiting at HIMSS. It occurred to us that Platinum sponsor O’Toole Law Group, aka Bill O’Toole who also writes HITlaw for us, would be a rather forlorn figure sitting alone in a booth looking wise and stern in a lawyerly way, surrounded by adjoining booths full of boisterous demo dollies and card trick magicians. So here’s the deal: Bill will be at the conference, but not in a booth, so you can read more on his Web site and make arrangements to connect with him at HIMSS to talk about HIT negotiations, non-compete agreements, and contracting (especially for Meditech shops). I told him I was going to mention (he probably thought I was kidding) that he will be at the HIStalk reception, so you can corral him there as well since that’s a good place to mix business with pleasure (if those terms aren’t synonymous, you’re doing it wrong). Bring your business cards.

One thing I like about having HIMSS in Atlanta: like Orlando and (formerly) Dallas, it’s cheap. Not just flights and hotels, but all-day convention center parking, gated and guarded, is only $10 or less. It snowed in Atlanta last week, but will be back up into the 50s by this weekend, which is the average daily high for March. The rooftop patio at Max Lager’s will be heated, so snow refugees can maybe get some outside air that won’t freeze their nose hairs. I also notice that some of the vendor bashes conflict with Sunday’s opening reception, which I think is a fantastic idea because I hate the opening reception.15,000 people elbowing each other to try to get a drink and an eggroll while a lame band plays isn’t fun for me, although I did like the San Diego one because the patio setting was so nice. Chicago was the worst ever, cramming a room with the charm and acoustics of an airplane hangar with bad music and a gazillion freezing people trying to get out of the ugly snowstorm outside. Can we admit, as HIMSS has tacitly done by vowing not to return to McCormick Place, that having the conference there in the first place was a really stupid idea like everybody kept trying to tell them? My almost-$300 hotel room was dumpy, everything from cabs to convention center coffee was overpriced, and there wasn’t anything to do except hang around the exhibit hall (which was the whole point of having it there instead of somewhere nice, of course).

Speaking of HIMSS events, soon-to-be announced Platinum sponsor MEDecision is having theirs on the same Monday night as the HIStalk one, but they are inviting HIStalk readers to drop over to their “HIStalk Pre-Party” from 6 until 7 Monday evening at the Georgia Aquarium. That event has the 2010 Grammy winner performing that I mentioned before, although I don’t know who it is (I would have guessed the Zac Brown Band since they’re from Atlanta and don’t start their tour until March 2, but really, I have no idea). The ever-diligent and protective Inga insisted on doing some research before giving me the OK to mention their event: “If you plan to go to both, you better drink fast and don’t go dunking in the shark tank. It looks like it is half a mile away, a 10-minute walk to Max Lager’s unless you are wearing your stilettos, in which case it is a two-minute cab ride.” Register here.

From the Weird News Andy vault: “at least he has a reason for not dancing.” A British hospital’s prosthetic limb specialist is fired after fitting an amputee’s right leg with an artificial left foot that was also one size too big. Paramedics noticed that the man was listing to one side, but he didn’t think much of it until taking off the fake foot’s protective sock five months later and saw a left foot on his right leg.

Last chance: please take my reader survey. Thank you. Speaking of which, a couple of readers had a good idea that I saw when I peeked at the results so far: a good time to read HIStalk (other than when it first comes out and you get the e-mail) is when you’re on a boring conference call or taking a lunch break at your desk. It’s like when I read the Howard Stern Show online recap at lunchtime: a guilty pleasure ideally suited for quiet time at work when you need a break (and this is even work-related, so you can read it guilt free).

Focus Informatics, Inc., a transcription provider that’s part of Nuance, has some job openings I said I would mention: a manager of US operations, account manager, team leader, and MTSO recruiter. Remote/virtual is OK.

Listening: reader-recommended Grace Potter and the Nocturnals, excellent Vermont-based throwback blues-rock with the female lead sometimes powering a vintage Hammond B3 organ or a big ole’ Flying V guitar. Video here. It’s cool that readers (some of them, like in this case, a top executive you would never expect) have figured out the music I like by my recommendations, then make their own back to me, generally with uncanny accuracy.

I am thankful that HIStalk’s sponsors nearly always stay with us. We lose one occasionally for one reason or another, but even then, they often find themselves missing the incessant good cheer of Inga the Sponsor Diva and end up returning to the fold. The InteGreat EHR folks have rekindled their Platinum flame after a short break and we welcome them back. As a refresher: the InteGreat EHR is modular, intuitive, browser-based, and CCHIT08 certified.

Speaking of sponsors for which we are grateful, here’s a new one: iSirona. The company specializes in capturing and delivering patient data: interfacing with stationary and mobile medical devices, providing  point-of-care charting screens, supporting positive patient ID, and streamlining charting and documentation workflow. Founder and CEO Dave Dyell said it better than I could in an HIT Moment With from May. Welcome and thanks to iSirona.

Nashville’s city government will spend money to buy clinical systems for Nashville General Hospital at Meharry, hoping to break even on the deal since the cost is $3.2 million and an even bigger government (the federal one) will pay it an estimated $4 million in return. Nobody’s mentioning any benefit to actual patients, but this is about stimulus.

Microsoft is opening some kind of health research center in Spain, interested in a location near a hospital that developed its “Florence” system using Microsoft technologies. This article says it includes smart phone access and SMS messaging. 

China’s $124 billion effort to move from socialized to US-like privatized health models is causing US-like problems: funding cuts, a dramatic polarity between services available to the rich and the poor, and rapid cost increases as doctors are financially motivated to order more drugs and tests. It’s so hard to get a hospital appointment that scalpers are openly selling appointment slots on hospital property (note to self – develop an eBay clone site to capitalize on this unauthorized secondary market).

Hospital-associated outpatient doctors can no longer qualify for ARRA meaningful use incentives after a Senate change to the HIRE Act. That may be addressed in other bills, however.

An odd situation caused by often-phony marijuana clinics: can an employee be fired for failing a drug test if he or she has a “marijuana card?” Marijuana is legal for medicinal purposes in 12 states, but only Rhode Island has a law preventing users from being fired for using it. Pot smokers are claiming they are being discriminated against, with theoretical legal claims under the Americans With Disabilities Act looming.

I’ve never heard of this: St. Vincent’s Hospital Manhattan, desperately trying to keep the doors open, lays off 32 medical residents as part of its 300 FTE headcount reduction. You know you’re in trouble when you can’t afford in-house physicians for 80 hours a week at $50K or so per year, or around $12 an hour.

Odd lawsuit: the family of a leukemia patient who died of Legionnaires’ Disease contracted from a water fountain gets a $1.2 million settlement from Ohio State University Medical Center. Nurses were told to give patients bottled water and to instruct them to avoid the fountains, but nobody put up signs. Strangely enough, the man’s daughter was nurse on the same floor and was with him at the time, but forgot to tell him not to use the fountain. Seems to me she’s responsible as well, but I doubt anyone is contemplating a lawsuit against her.

HIMSS posts its list of companies presenting at the all-day Health IT Venture Fair on Sunday, February 28. The list:

• Axial Exchange, an integration appliance vendor started by former Red Hat execs
• CareCloud, which offers Web-based practice management applications
• Clarity Health Journal, a PHR tool
• Dicom Systems, which offers a DICOM router and archive
• EDIMS, a vendor of emergency department information systems (and an HIStalk Platinum sponsor)
• Envisioner Medical Technologies, a personal medical imaging platform for endoscopic multimedia
• Heart Imaging Technologies, which offers a Web-based PACS, clinical trials system, and image sharing site
• Logical Images, vendor of a visual diagnostic system based on medical photographs
• Medical Diagnostic Associates, offering systems for electronic images and exam tracking for diagnostic imaging
• MedCPU, a clinical practice tool for high acuity hospital services including OB
• MedicExchange, a social networking and product review site for healthcare professionals
• MediViz Systems, a real-time decision support system for the OR
• Mensante, operator of FeelingBetterNow, a best practices site for Canadian mental health physicians and patients
• Polaris Health Directions, which offers behavioral health outcomes assessments and management systems
• Prodigo Solutions, a healthcare supply chain applications vendor
• Provider Advantage, EDI systems
• Sentient Health, supply chain systems
• Smart Association, smart cards
• Spring Medical, vendor of SpringCharts EHR
• TC Software, which sells an integration engine
• White Pine Systems, which offers a PHR
• Your Nurse Is On, an online tool that matches nurses to open shifts
• Zebec Data Systems, a IT infrastructure hosting and outsourcing vendor

The most common mistakes companies make pitching at the Venture Fair, from my limited experience in having crashed part of it once:

1. Not being able to summarize their offering in ten seconds.
2. Not being able to clearly explain right off the bat who their potential customer base is, what problem they intend to solve for them, and how they plan to efficiently reach those prospects with their message.
3. Saying “we don’t really have any competition” when inevitably asked.
4. Not knowing what it costs to get a customer (or worse, having no customers).
5. Pitching an unoriginal idea, an idea that’s interesting but not really much of a business to deserve outside investment, or an idea that requires competing against well-established competitors that could extinguish you in a corporate heartbeat.
6. Trying to hide modest numbers by not bringing any. Investors understand that early-stage companies aren’t often making a profit, but not having a handle on revenue and expenses is inexcusable.
7. Shooting for quantity instead of quality, spouting off an undisciplined array of ideas instead of focusing on one potential winner. Diversification comes later; focus reduces upfront risk.
8. Not really understanding the difference and expectations among funding options such as bank financing, friends and family, angel investors, private equity, and venture capital.
9. Taking up too much time with a product demo instead of talking numbers, management experience, and growth strategy.
10. Being an inexperienced, unpolished entrepreneur looking for a large investment (investors bet on the jockey, not the horse).
11. Trotting out wildly optimistic revenue projections that always start immediately after someone else puts their money in.
12. Asking for someone else’s money when they haven’t put in much of their own or when still running the business part time.
13. Having a management team made up of product people (i.e. geeks) and nobody with startup and management experience.
14. Not having an advisory board or mentor who has done it before.
15. Having only a vague story about how investors will get their money back and how the company will mitigate the risks that arise between the time they write you a check and the time when you return the favor.
16. Not having a detailed plan on what they plan to do with it (it better involve increasing revenue directly, not leasing an office or buying Aeron chairs for everyone).
17. Being too undisciplined or excited to stick to the venture fair’s limits on PowerPoint slides and session duration, or having glaring errors in the information sheet. This is speed dating, not courtship, so first impressions are the only kind.
18. Expecting to get someone else’s money without giving up some negotiable degree of control.
19. Expecting to walk out of the room with a deal or assuming that some degree of audience interest means you’ve scored. I don’t know what the hit rate is for the venture fair, but I bet it’s low.
20. Getting discouraged instead of vowing to learn from the experience, to make the business and the pitch better for next time, and to try again.

E-mail me.